One of the struggles many new companies have is the transition from a scrappy startup to an established and respected company. This has been notable in the news as Uber has now made repeated attempts to change and establish itself. For companies, this means the transition from impromptu meetings, a general lack of structure, and a pace of work that, while doable for a year or two, is not sustainable for decades. Many people have great ideas in their garage; very few people are able to take their great ideas and organize a sustainable company around those ideas.

Although different than companies, in some ways our lives are very similar. Many people begin with creative ideas and high hopes for changing the world around them. However the transition from idea to instrumentation is the burial ground for many commendable pursuits. The transition from spectator to player is key. Whatever pursuit you are thinking of, whether that be a sport, a hobby, a new invention, a business idea, the beginning of a political career, or any number of things, the first step onto the field is key. Often the thing holding us back from becoming a player is complacency and a fear of a new experience. Often the first step does not have a high opportunity cost. Instead the cost is a bit of comfort to establish a new identity. Growth is embracing the discomfort, digging in for the long haul, and deciding that whatever we are pursuing is ultimately of greater value and worth than the comfort we are leaving behind. 

“The man who views the world at 50 the same as he did at 20 has wasted 30 years of his life.”

-Muhammad Ali

Like the proverbial frog slowly brought up to a boil, we are often immune to gradual change. Asked how we are different from yesterday most of us could not see many differences. Even at a week or a month much of who we are may appear the same. Looking back from year to year we can begin to detect the changes. How was I different last year? Five years ago? Ten years ago? As Muhammad Ali notes, the answer must never be “no different”. An essential component to being human is the constant changing of our core selves. The best stories, whether fiction or non-fiction, movie or book, are those in which the characters change, become people their former selves would barely recognize. Take your favorite story, Harry Potter, Lord of the Rings, Star Wars, the Hunger Games, or any other. The most compelling aspect of that story is the dynamic nature of the main character, watching them morph and change as events unfold. Take your own story, your life. How have you changed? How have I changed? Have we changed in a way that makes a great story? Or are we mired in a static bog of routine and comfort? The great news is that the end of our stories has yet to be written and the opportunity for change and growth waits.

A beginning, a middle, an end. These are essential components of nearly all of our experiences. The beginning exciting and invigorating. The middle often repetitive, even monotonous. The end bittersweet and nostalgic. This cycle, these three elements are what imbue every undertaking with meaning and purpose. Whether in education or business, recreation or occupation, at the personal level or at the national level, we function best when these elements are well defined. The repetitive nature many careers take. And the later years of contemplation and reflection before final goodbyes are said. We see this in trips, the excitement while packing and traveling, the rhythm of being away from home, before solemn farewells and departures.  We see this over the course of lifetimes, the learning curve of being a child, a student, and a young member of the workforce. In the movie “In Time” where unending life can be bought for the right price one of the main characters observes that although the body can live forever, the mind cannot. We were made to have a beginning, a middle, and an end.

And there is a blessing in that. We understand poorly the process of aging, why the body breaks down, why even with the optimal lifestyle a hard ceiling to longevity exists. Likely within the next 50 years much of this mystery will be unraveled forcing us to ponder what we might do with an end postponed. Would we use our time differently? Invest in the planet and environment more? Harbor less ill will (grudges accumulated over centuries would certainly be oppressive)? Yet in our current state we must do what we can with the time we have. Making the most of our opportunities and our relationships.

The admission, and also the celebration, at the center of Christianity is that “I am nothing.”  The human bend is to strive to be something, a desperate plea that “I am something, I am someone.” Much of our daily lives is consumed with that pursuit. In career it is to demonstrate you add to the company or team. In society it is to demonstrate your skills are valued and add to others. In relationships it is to know you matter to the other person. Christianity reverses this. It accepts that we are nothing and even at our best fall short of being something or someone. Importantly it accepts that we are in so far over our heads that we need a savior. That our best strivings and a lifetime of good deeds and effort will still see us short of worth. There are two general ways of recognizing a need for a savior- looking inward and looking outward. When we look inward, a realistic self-evaluation (and this is often the most difficult, as Richard Feynman said “The first principle is that you must not fool yourself, and you are the easiest person to fool.”) we see a degree of selfishness, angst, anger, discontentment, insecurity, and loathing requiring us to look away. When we look outward we see the brokenness of the world, both natural and human derived, that destroy our hopes for a better world. Looking both inward and outward the brokenness is apparent. Instead of looking for distraction or a stubborn refusal to admit defeat, the Christian must joyfully embrace this defeat admitting brokenness and a desperate need for a savior. at its essence, being a Christian is a simple progression: (1) making an observation of brokenness both in ourselves and in our world, (2) accepting that at our best we are incapable of being the someone or something we desired, and (3) looking to a savior who can fix the brokenness inside and outside.

The more I understand the human body, all the organs and tissues, all the complex interactions between systems and cells, the more I am amazed not at how terrible disease is (and disease is terrible), but how often things go right in the body. It is amazing how often all the systems come together to allow simple actions like breathing, stretching, walking, and thinking. Take none of this for granted. Every moment, every opportunity should be seized and enjoyed with great gratitude. 

The common trend we see in the online community contains one step: React. More than a handful of times I have seen posts on social media in which the person acknowledges they have not read the item they are critiquing yet immediately following that admission they proceed to provide a uniquely, and by their own admission, unqualified, analysis. Ignorance is a luxury that we as a nation, we as a global civilization, cannot afford. We ourselves cannot be afford to be ignorant, nor can we afford to allows others to continue in ignorance simply because they do not have the means to invest in education. Either the solution to this problem or the cause of the problem will be the internet. The internet provides a solution in that it enables access to a vast amount of information. However, there is virtually no filter on the quality of information online and often the effort to fact check and think critically about the information presented is time consuming and difficult. However this time and effort is what is required to maintain democracy and forward progress. Each person must synthesize their own thoughts from what they have read instead of parroting popular taglines. Contrary to what many political systems attempt to persuade us of, one does not simply decide whether they are on the right or the left. Instead one must think about each important issue and decide on that issue what they believe. Instead of a one movement reaction, we must move intentionally to inform ourselves and formulate our own ideas. This is the cost of democracy. Democracy is not guaranteed and there are certainly a multitude of people waiting to take it away. An educated and informed population refusing to buy into partisan lines must be our defense against this. Read. Think. React.

Academia, as well as life in general, is a strange mix of learning, doing, and teaching. The true innovators are those that are able to balance all three. Learning must come first. Hone your craft, incorporate new techniques and new knowledge. Then do. Create and cultivate. Finally pass on your knowledge and skills to those behind you. Bring them alongside you and motivate them to become excellent in their own rite. In the past I’ve done a lot of learning, a fair amount of doing, and some teaching. The more I do and teach, the more I realize how incredible the teachers and mentors are that are able to both teach and do simultaneously. Attendings (Supervising Physicians) are tasked with both maintaining patient care at a high level as well as teaching the residents and medical students who are training under them. The best attendings meld the two together seamlessly using patient care to train residents and utilizing residents to accomplish patient care. This is true in many areas of life. In research, in business, in education, those affecting the most change are those leaders who can teach and do together. Those to whom teaching is doing and doing is teaching. Learn. Do. Teach.

I recently came across a quote by Gary Vaynerchuk, an entrepreneur and innovator. Noting that everyone has 24 hours in a day and six hours a day is required for sleep, each person still has eighteen hours each and every day to spend however they so choose. For those that need seven hours of sleep that leaves seventeen hours, still a sizable chunk of time. Most people wake up, work, and then have the evening hours to themselves. For those younger people, this time often is open with time for socializing and entertainment. For those with families often much of this time is spent engaging in family activities, doing chores, and preparing for the next day. Certainly there are phases of life- with young children, during an illness, etc- in which the evening or early morning are packed full, however this is the exception instead of the rule. Much of the evening and late night of the modern adult is filled with entertainment. Movies, books, TV shows, video games, browsing the internet, and social media. In most cases these activities do not build strong social ties (yes, even social media) or generate productivity in another way.

They say that if you love what you do vocationally you will never work a day in your life. While this is not purely true, there is certainly something to be said for have work that you love. When I am on a project I enjoy I think about it constantly- while walking in, while eating, while running, and while walking home. Much of the evening time (between 7pm and 1am), is spent working on those projects because they are entertainment in and of themselves. This is the goal, to have your work be so engaging and have such a purpose that it can be your entertainment. Regardless of your work, whether you find the 9 to 5 enjoyable or not, the 7 to 1 is yours to create and do whatever you would like. Don’t waste that opportunity.

The political climate surrounding the issue of healthcare reform which has been charged for some time, seems to be reaching a climax in the United States. Reading and hearing the opinions voiced (sometimes shouted) by others one thing becomes apparent. (1) We all agree that the system is less than ideal. However, I have also found it troubling that everyone is concerned about what the government should do. Interestingly both sides leverage the same religious principles and ideals to justify opposing positions. The argument is that if we love our neighbor as our loftiest religious ideals describe, we would support one form of government healthcare reform or another. And herein lies the problem. Instead of taking responsibility for loving our neighbor, for giving to the poor, and to caring for the sick at the personal level regardless of the healthcare laws, we push the responsibility of loving onto the government.

Interestingly, neither group seems to be seeking out ways to give. The government is not the only way to give. Neutral analysis shows very clearly that the government programs are not the most efficient ways to be charitable. The government simply has the power to do what other charities cannot- force people to give*. What we need is not a revamping of a government program forcing people to give, but rather a change in how people see others and how willing they are to give. If members from both sides of the spectrum spent their time trying to figure out how to give more of their money away more effectively, healthcare reform would not be a problem. But instead members from both sides hold signs, give speeches, sign petitions, and make posts on social media about their political cause.

Charities have rapidly realized that the best way to get people to give is not by giving impressive statistics but by sharing personal stories. When we push all of our charitable work onto the government, we lose any personal story and see only statistics. When we engage with one another, when we let our needs be known and get to know other’s needs, that is when we are most charitable and affect the greatest change. Dollar for dollar and hour for hour it would be far more effective to fund every gofundme healthcare page or fund the private charities than to fund large healthcare programs with high overheads and little good will towards those they help. But the problem is us. The problem is you. The problem is me. We don’t give willingly, and rarely generously. Instead, we need to be forced to give. So we resort to large programs, with high overheads, and political battles that cause little change. It is our hearts, not the programs, that need rewriting.

If you believe that the affordable care act should be rejected and rewritten you have a responsibility to give to the sick, to feed the poor, to help the needy because that is not the government’s job anymore; it’s your job. It’s my job. If you believe that the affordable care act should be kept or expanded you have a responsibility to the sick, to feed the poor, to help the needy because the government cannot take care of all the hurt in the world. If you believe that money should be redistributed to the neediest, start now, there is no need to wait for a government mandate. Love now, give now. This is your job. It’s my job. Only when we love, when we care, when we give at the personal level, seeking out opportunities to give generously instead of waiting to be forced to give by an inefficient government program, can any real change happen.

* and borrow large amounts of money without a plan to repay-but we will save that topic for another time

Considering our place in evolutionary history, one of the most interesting, yet confusing ideas is the fact that we are the result of billions of years of evolution yet are also the substrate upon which natural selection is currently working. This is interesting in the fact that one can think about our bodies and minds as being perfected by all those millenia, yet being so imperfect as to require many millenia more of perfecting. In reality, there is no perfect organism in an environment that is continually changing. What is ideal one decade may be highly unideal the next if the environment changes quickly.  Humans have managed to step outside of this constraint in some ways as we are, of all the other species on the planet, the most able to change the environment around us. In many ways, this enables us to shape the natural selection being applied to our species. This should terrify us. 

Reworded, our ideas, turned into actions, are now the actual force changing how our species evolves. In many aspects this is good. Many people benefit from the ability to wear eyeglasses, stay warm when it is cold out, or store food for long periods of time. However we must realize that anytime we alter the environment, we change the course of evolutionary history. The risk of unintended consequences, no matter how good the intentions, is high. However the opportunity to do good for our species and the other species inhabiting our planet is also immense. To crib Uncle Ben from Spiderman, “With great power comes great responsibility.“